Recurrent Radiation-Induced Angiosarcoma of the Breast Without Distant Metastasis: A Case Report

Radiation-induced sarcomas represent a rare but aggressive complication following breast cancer treatment, often associated with significant biological heterogeneity and limited therapeutic options. Their clinical course is frequently characterized by high recurrence rates and limited responsiveness to conventional therapies. We report a case of a 76-year-old female with a history of left-sided breast cancer treated in 2017, who subsequently developed a high-grade radiation-induced soft tissue sarcoma of the chest wall. The patient underwent multiple surgical resections due to recurrent disease. Systemic treatment included exemestane as endocrine therapy and pazopanib as antiangiogenic targeted therapy, both administered according to a consistent daily schedule. Laboratory findings demonstrated a relatively stable neutrophil-to-lymphocyte ratio of approximately 3.0-3.5 in the context of a persistent inflammatory profile. Despite aggressive tumor biology and multiple comorbidities, the patient maintained a relatively stable clinical condition without evidence of distant metastasis. An additional observation in this case was the consistent daily timing of systemic therapy administration. While not formally evaluated, this pattern may represent a potentially relevant aspect of treatment delivery and could warrant further investigation.